This invention relates to drug delivery and gene therapy. More particularly, the present invention provides methods and apparatus for the delivery of drugs or gene therapy, or both, into a patient""s vasculature.
According to the National Cancer Institute, approximately 4,000 specific conditions are known to be caused by genetic defects. The GeneMed Network states that each human being carries roughly a half dozen defective genes, and that about one in ten people has or will develop an inherited genetic disorder.
A composite of approximately 150,000 individual genes constitutes a human being. Variation in the structure of these genes can lead to disease. Many diseases are hereditively passed by a single gene, while many others are influenced by a collection of genes.
Several years ago, the Human Genome Project began mapping every human gene. The project is fostering an understanding of the very foundation of human disease and is enabling new therapies to treat and predict the onset of disease. One such therapy is gene therapy, which seeks to directly and beneficially modify the expression of genes through delivery of engineered genetic material. Foreign nucleotide sequences of either DNA or RNA are inserted into a patient""s cells to result in either expression of non-integrated sequences or integration of sequences directly into the DNA of the cells.
Safe and efficient delivery of nucleotide sequences to appropriate cells poses one of the primary challenges to gene therapy. Vectors, which encapsulate therapeutic genes, have been developed to deliver the sequences. These vectors may be either viral or synthetic. Viral vectors, derived from viruses, are the primary vectors in experimental use today. Viruses efficiently target cells and deliver genome, which normally leads to disease. However, viral vectors for gene therapy are modified so that they may not cause disease. Rather, therapeutic recombinant genes are inserted into the vectors and delivered to target cells. Optimally, the modified viruses retain their ability to efficiently deliver genetic material while being unable to replicate.
Research in the field of gene therapy is still in the formative stages. Human trials only began in 1990 with ex vivo techniques, wherein a patient""s cells were harvested and cultivated in a laboratory and incubated with vectors to modify their genes. Cells were then harvested and intramuscularly transplanted back into the patient. Trials quickly shifted to in vivo techniques, in which viral vectors are administered directly to patients, again intramuscularly. A variety of diseases are currently being evaluated as candidates for gene therapy, and a need exists in the art for improved vector delivery techniques.
While significant progress has been made, current gene therapy delivery techniques have many drawbacks. Viral vectors are inherently dangerous due to the innate ability of viruses to transmit disease. Furthermore, long-term effects of using viruses as delivery vehicles are unclear. Chances for error in modifying the viruses to vectors are significant, and consequences may be substantial, including potential irreversible alteration of the human gene pool. Also, delivery of the vectors to an efficacious portion of diseased cells has proven difficult and expensive.
Synthetic vectors have been developed to address the potential for disease transmission with viral vectors. These vectors are complexes of DNA, proteins, or lipids, formed in particles capable of efficiently transferring genes. However, synthetic vectors have thus far proved less effective than viral vectors and have been slower to gain acceptance.
Perhaps even more problematic than limitations of the vectors, intramuscular in vivo techniques, wherein vectors are delivered into a patient""s muscle tissue, have proven somewhat ineffective in clinical use. Systemic expression of inserted sequences is not realistic since therapy is localized.
In view of the drawbacks associated with previously known methods for delivery of gene therapy, it would be desirable to provide methods and apparatus that overcome such drawbacks.
It further would be desirable to provide methods and apparatus for delivery of gene therapy that mitigate the risk of disease transmission.
It still further would be desirable to provide methods and apparatus for providing localized delivery of genes or bioactive agents that are relatively inexpensive, as compared to current techniques.
It would be desirable to provide methods and apparatus for delivery of gene therapy that are suited for systemic delivery of viral vectors, synthetic vectors, drugs, or other therapeutic agents.
It would also be desirable to provide methods and apparatus that efficiently deliver genes to an efficacious portion of diseased cells.
In view of the foregoing, it is an object of the present invention to provide methods and apparatus for delivery of gene therapy that overcome drawbacks associated with previously known methods and apparatus.
It is also an object of the present invention to provide methods and apparatus that mitigate the risk of disease transmission.
It is another object to provide relatively inexpensive methods and apparatus for localized delivery of genes or bioactive agents.
It is an object to provide methods and apparatus for delivery of gene therapy that are suited for systemic delivery of viral vectors, synthetic vectors, drugs, or other therapeutic agents.
It is yet another object to provide methods and apparatus that efficiently deliver genes to an efficacious portion of diseased cells.
These and other objects of the present invention are accomplished by providing methods and apparatus for the delivery of gene therapy that expose one or more recombinant genes directly to a patient""s bloodstream in a region of diseased tissue. A significant portion of blood that come into contact with the genes, which may or may not be encapsulated in vectors, is expected to incorporate the genes directly into its genome.
In a preferred embodiment, apparatus of the present invention comprises an eluting material held in place within a patient""s vessel by an anchor. The anchor and eluting material are sized and/or expandable from a delivery configuration, in which the mechanism and material may be delivered into the patient""s vasculature within a delivery sheath, to a deployed configuration, wherein the anchor engages an interior wall of the patient""s vessel. The eluting material may elute recombinant genes, or, alternatively, it may elute drugs or other bioactive or therapeutic agents.
Methods of using the present invention also are provided.